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Zomer L, van der Meer L, van Weeghel J, Widdershoven G, de Jong I, Voskes Y. Recovery-oriented care in Teams Working with the ART Model in long-term Mental Health care: A Qualitative Study on the Experiences of Service Users and Their Significant Others. Community Ment Health J 2024; 60:1177-1190. [PMID: 38619696 PMCID: PMC11199278 DOI: 10.1007/s10597-024-01269-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 03/16/2024] [Indexed: 04/16/2024]
Abstract
The Active Recovery Triad (ART) model provides a framework for recovery-oriented care in long-term mental health settings. The aim of this study is to gain insight into the experiences and views of service users and their significant others regarding care and support they receive from teams working with the ART model. Semi-structured interviews were performed with nineteen service users and five significant others of teams operating in Dutch long-term mental health care. Data were analyzed using thematic analysis. The three core principles of the ART model formed the deductive basis of the analysis and for every principle themes were identified inductively. Under the principle 'Active', service users mentioned that they feel motivated, work actively on personal recovery goals and have dreams for the future. Service users valued the service as a safe environment, but several service users also preferred to live more independently. Under the principle 'Recovery', participants reported how the dimensions of recovery (health, personal identity, daily life and community functioning) were addressed in care and support. Also, specific conditions for recovery-oriented care were identified, for example regarding specific expertise of care providers. Under the principle 'Triad' the support from significant others, contact with care workers and with other service users were identified as important. The insights regarding what is important for service users and their significant others may contribute to the improvement of care and support in long-term mental health care. In addition, the findings of this study provide directions for the further development of the ART model.
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Affiliation(s)
- Lieke Zomer
- Department of Ethics, Law and Humanities, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands.
- Altrecht GGz, Zeist, the Netherlands.
| | - Lisette van der Meer
- Department of Clinical & Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
- Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, the Netherlands
| | - Jaap van Weeghel
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, Tilburg, the Netherlands
| | - Guy Widdershoven
- Department of Ethics, Law and Humanities, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
| | - Isa de Jong
- Department of Ethics, Law and Humanities, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
| | - Yolande Voskes
- Department of Ethics, Law and Humanities, Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, Tilburg, the Netherlands
- Impact Care Group, GGz Breburg, Tilburg, the Netherlands
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Zomer L, van der Meer L, van Weeghel J, Widdershoven G, Voskes Y. From Model to Practice: A Qualitative Study on Factors Influencing the Implementation of the Active Recovery Triad (ART) Model in Long-Term Mental Health Care. J Clin Med 2024; 13:3488. [PMID: 38930017 PMCID: PMC11205107 DOI: 10.3390/jcm13123488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/17/2024] [Accepted: 06/09/2024] [Indexed: 06/28/2024] Open
Abstract
Background: The Active Recovery Triad (ART) model provides a framework for recovery-oriented care in the long-term mental health setting. The aim of this study is to gain insight into factors influencing the implementation process of the ART model. Methods: Focus groups were conducted with fourteen multidisciplinary teams that were in the process of implementing the ART model. Data were thematically analyzed. Results: Three phases of implementation were identified. In the first phase, getting started, support from both the top of the organization and the care workers, sufficient information to care workers, service users, and significant others, and creating momentum were considered crucial factors. In the second phase, during implementation, a stable team with a good team spirit, leadership and ambassadors, prioritizing goals, sufficient tools and training, and overcoming structural limitations in large organizations were seen as important factors. In the third phase, striving for sustainability, dealing with setbacks, maintaining attention to the ART model, and exchange with other teams and organizations were mentioned as core factors. Conclusions: The findings may support teams in making the shift from traditional care approaches towards recovery-oriented care in long-term mental health care.
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Affiliation(s)
- Lieke Zomer
- Department of Ethics, Law and Humanities, Amsterdam University Medical Centers, 1081 HV Amsterdam, The Netherlands
- Altrecht GGZ, 3705 WC Zeist, The Netherlands
| | - Lisette van der Meer
- Department of Clinical & Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
- Department of Rehabilitation, Lentis Psychiatric Institute, 9470 AC Zuidlaren, The Netherlands
| | - Jaap van Weeghel
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, 5037 DB Tilburg, The Netherlands
| | - Guy Widdershoven
- Department of Ethics, Law and Humanities, Amsterdam University Medical Centers, 1081 HV Amsterdam, The Netherlands
| | - Yolande Voskes
- Department of Ethics, Law and Humanities, Amsterdam University Medical Centers, 1081 HV Amsterdam, The Netherlands
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, 5037 DB Tilburg, The Netherlands
- Impact Care Group, GGz Breburg, 5017 JD Tilburg, The Netherlands
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Salberg J, Ekselius L, Hursti T, Öster C. Staff experiences related to implementation of a recovery-oriented nursing programme in psychiatric inpatient care. Int J Ment Health Nurs 2022; 31:731-742. [PMID: 35315194 PMCID: PMC9311143 DOI: 10.1111/inm.12995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 02/28/2022] [Accepted: 03/11/2022] [Indexed: 11/28/2022]
Abstract
Nursing in psychiatric inpatient care is peripheral to a dominating biomedical model of care. Efforts are being made to implement nursing models based on core values and theories for nursing, such as recovery-oriented practices. The aim of the study was to explore experiences of a recovery-oriented nursing programme (Steps Towards Recovery, STR) among nursing staff in psychiatric inpatient care and their ratings of stress (Maslach Burnout Inventory scores), quality of care (Quality of Psychiatric Care - Inpatient staff scores) and satisfaction with nursing care (Satisfaction with Nursing Care and Work scale scores), before and after the implementation-and compare with ratings from reference wards. A quasi-experimental and prospective, pretest-post-test design was used. Specific questions about the nursing programme were answered by staff at the intervention wards. Staff reported predominantly positive experiences of the nursing programme. At follow-up, higher ratings were reported in two dimensions of quality of care in the STR group, and lower ratings in one dimension of stress were evident in the reference group. No differences in ratings between the STR and reference wards were found. Staff members' positive experiences of STR and higher ratings regarding participation and secure environment after implementation suggest that STR is a well-accepted and promising nursing programme. It is important to implement and evaluate recovery-oriented interventions in psychiatric inpatient care, where a focus on symptom relief still prevails. The results indicate that there is potential for further exploration of STR in this context.
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Affiliation(s)
- Johanna Salberg
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Lisa Ekselius
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Timo Hursti
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Caisa Öster
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
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Wangensteen T, Hystad J. Trust and collaboration between patients and staff in SUD treatment: A qualitative study of patients’ reflections on inpatient SUD treatment four years after discharge. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 39:418-436. [PMID: 36003119 PMCID: PMC9379296 DOI: 10.1177/14550725221082366] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 02/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background and aim: Substance use disorder (SUD) is multifactorial, complex, and involves the severe problematic use of alcohol, prescription drugs, and other substances. People with SUD have long histories of perceived stigma, marginalisation, exclusion, social isolation, and shame. Moreover, patients with SUD are often treated as untrustworthy and incapable of actively participating in their treatment planning, even by healthcare and social services workers. Methods: Through in-depth interviews with former patients who have undergone SUD treatment, we explored their reflections on the treatment content. Interpretative phenomenological analysis revealed that some informants experienced aspects of the treatment as valuable, whereas others considered the same treatment useless or harmful. Results: Essential aspects of treatment were developing self-esteem and optimism about the future, developing strategies for coping with stress and challenging emotions and situations, developing relationships with family and friends, and preparing for life after inpatient treatment. Relationships with staff were described as crucial in all parts of the treatment. Conclusion: In conclusion, we suggest that a transition to a more collaborative treatment philosophy would be ethically and professionally valuable for providing support and treatment and enhancing patients’ perceptions of empowerment, inclusion, participation, and well-being on their terms, in cooperation with supportive others.
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Vandewalle J, Debyser B, Deproost E, Verhaeghe S. Family expectations of inpatient mental health services for adults with suicidal ideation: a qualitative study. Int J Ment Health Nurs 2021; 30:1136-1148. [PMID: 33817944 DOI: 10.1111/inm.12864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2021] [Indexed: 12/15/2022]
Abstract
Involvement of family members of adults with suicidal ideation is a key area of improvement in inpatient mental health services. To support family involvement in this context, it is crucial to understand what care and treatment family members expect for their relative. This qualitative study based on grounded theory involved interviews with 14 family members, including partners, parents, adult children and siblings. The family members' expectations of care and treatment in inpatient mental health services were captured by the core element 'Struggling to remain hopeful while looking through the lens of uncertainty'. This core element interacted with four sub-elements: assuming safety as a priority, looking for a healing approach and environment, counting on continuity of care and wanting to be involved and supported. The family members fluctuated between hope and uncertainty depending on whether their expectations were met or unmet. Unmet expectations were common and underpinned by a sense of being marginalized during the admission of their relative with suicidal ideation. Mental health professionals, including nurses, can be more empathetic towards the family members and attuned to their expectations. This can underpin partnerships that help families to deal with their feelings of uncertainty and disempowerment. Such partnerships can flourish in recovery-oriented mental health services that allow meaningful family involvement.
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Affiliation(s)
- Joeri Vandewalle
- University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Psychiatric Centre Sint-Amandus, Beernem, Belgium
| | - Bart Debyser
- University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Centre for Psychiatry and Psychotherapy, Clinic Sint-Jozef, Pittem, Belgium.,Department of Nursing, VIVES University College, Roeselare, Belgium
| | - Eddy Deproost
- University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Centre for Psychiatry and Psychotherapy, Clinic Sint-Jozef, Pittem, Belgium
| | - Sofie Verhaeghe
- University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department of Nursing, VIVES University College, Roeselare, Belgium
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